This paper gives a self-defence account of the scope and limits of the justified use of compulsion to control contagious disease. It applies an individualistic model of self-defence for state action and uses it to illuminate the constraints on public health compulsion of proportionality and using the least restrictive alternative. It next shows how a self-defence account should not be rejected on the basis of past abuses. The paper then considers two possible limits to a self-defence justification: compulsion (...) of the non-culpable and over-inclusive compulsion. The paper claims that objections to compelling the non-culpable do not greatly restrict the scope of the self-defence justification. The over-included are, however, innocent bystanders, and methods such as compulsory quarantine, vaccination, and screening are not justified in self-defence. (shrink)

Modelling contagious diseases needs to include a mechanistic knowledge about contacts between hosts and pathogens as specific as possible, e.g., by incorporating in the model information about social networks through which the disease spreads. The unknown part concerning the contact mechanism can be modelled using a stochastic approach. For that purpose, we revisit SIR models by introducing first a microscopic stochastic version of the contacts between individuals of different populations (namely Susceptible, Infective and Recovering), then by adding a (...) random perturbation in the vicinity of the endemic fixed point of the SIR model and eventually by introducing the definition of various types of random social networks. We propose as example of application to contagious diseases the HIV, and we show that a micro-simulation of individual based modelling (IBM) type can reproduce the current stable incidence of the HIV epidemic in a population of HIV-positive men having sex with men (MSM). (shrink)

The paper analyses John Stuart Mill’s harm principle and its proper application in the process of drafting and evaluating laws, political decisions, and measures used to prevent the spread of contagious diseases. By interpreting Mill as an epistemic democrat and an epistemic liberal, the paper focuses on Mill’s thoughts regarding the decision-making procedures appropriate for legislation in a pandemic. Additionally, it discusses the proper division of epistemic and political labor, one of the most important mechanisms Mill uses to filter (...) the public will, and demonstrates how Mill’s arguments can help us balance between epistemic and moral virtues, i.e. between democratic and expert-oriented decision-making. (shrink)

The conception of contagious disease that Girolamo Fracastoro provides in his work De contagione et contagiosis morbis, marks the origin of modern epidemiology and microbiology. This conception puts into play the Galenic and Aristotelian traditions of research, faced with its own conceptual limitations of the growing mechanistic thought of the time. According to Fracastoro, epidemic diseases spread by invisible living germs called seminaria, begotten by corrupted humours. Fracastoro resorted to the old notions of "sympathy" and "antipathy" to respond (...) to questions about how seminaria is transmitted from one body to another, and what is the specificity that limits its transmission to certain species and organs. Like Galileo and Descartes, Fracastoro tries to establish a dialogue in the field of medicine between the Aristotelian vitalism and the modern mechanistic perspective. The purpose of this paper is to highlight the ideological, theoretical and conceptual assumptions, both philosophical and scientific, assumed by Fracastoro with regard to the problem of contagion. (shrink)

This issue’s “Legal Briefing” column covers recent legal developments involving coerced treatment and involuntary confinement for contagious disease. Recent high profile court cases involving measles, tuberculosis, human immunodeficiency virus, and especially Ebola, have thrust this topic back into the bioethics and public spotlights. This has reignited debates over how best to balance individual liberty and public health. For example, the Presidential Commission for the Study of Bioethical Issues has officially requested public comments, held open hearings, and published a (...) 90-page report on “ethical considerations and implications” raised by “U.S. public policies that restrict association or movement (such as quarantine).” Broadly related articles have been published in previous issues of JCE. We categorize recent legal developments on coerced treatment and involuntary confinement into the following six categories: 1. Most Public Health Confinement Is Voluntary 2. Legal Requirements for Involuntary Confinement 3. New State Laws Authorizing Involuntary Confinement 4. Quarantine Must Be as Least Restrictive as Necessary 5. Isolation Is Justified Only as a Last Resort 6. Coerced Treatment after Persistent Noncompliance. (shrink)

Recent scholarship on the social history of health and medicine in colonial India has moved beyond enclavist or hegemonic aspects of imperial medicine and has rather focused on the role of Indian intermediaries and the fractured nature of colonial hegemony. Drawing inspiration from this scholarship, the article highlights the significance of the Indian subordinates in the lock hospital system in the nineteenth century Madras Presidency. This study focuses on a class of Indian subordinates called the “gomastah”, who were employed to (...) detect clandestine prostitution in Madras to control the spread of venereal disease. It also underlines the role of other native and non-native subordinates such as Dhais, Chowdranies and Matrons, the ways in which they became indispensable for the smoother operation of the Contagious Diseases Act and the lock hospitals on a day-to-day basis. By emphasising how Indian subordinates were able to bring in caste biases within colonial governmentality, adding another layer to the colonial prejudices and xenophobia against the native population, it underlines the fact that there was not a one-way appropriation or facilitation of the coloniser’s knowledge or biases by the colonised intermediaries. Rather, it argues for an interaction between them, and highlights the complexities of caste hierarchies and prejudice within the everyday colonial governmentality. Moreover, the article focuses on the consequent chaos and inherent power struggle between different factions of colonial staff. (shrink)

Recent scholarship on the social history of health and medicine in colonial India has moved beyond enclavist or hegemonic aspects of imperial medicine and has rather focused on the role of Indian intermediaries and the fractured nature of colonial hegemony. Drawing inspiration from this scholarship, the article highlights the significance of the Indian subordinates in the lock hospital system in the nineteenth century Madras Presidency. This study focuses on a class of Indian subordinates called the “gomastah”, who were employed to (...) detect clandestine prostitution in Madras to control the spread of venereal disease. It also underlines the role of other native and non-native subordinates such as Dhais, Chowdranies and Matrons, the ways in which they became indispensable for the smoother operation of the Contagious Diseases Act and the lock hospitals on a day-to-day basis. By emphasising how Indian subordinates were able to bring in caste biases within colonial governmentality, adding another layer to the colonial prejudices and xenophobia against the native population, it underlines the fact that there was not a one-way appropriation or facilitation of the coloniser’s knowledge or biases by the colonised intermediaries. Rather, it argues for an interaction between them, and highlights the complexities of caste hierarchies and prejudice within the everyday colonial governmentality. Moreover, the article focuses on the consequent chaos and inherent power struggle between different factions of colonial staff.ZusammenfassungDie jüngere Forschung zur Sozialgeschichte der Gesundheit und Medizin im kolonialen Indien hat sich jenseits spezifischer hegemonialer Aspekte der imperialen Medizin mittlerweile verstärkt der Bedeutung ihrer indischen Vermittler und der gebrochenen Natur kolonialer Herrschaft zugewandt. Davon inspiriert beleuchtet der Beitrag die Rolle indischer Subalterner im System der Krankenhäuser für Geschlechtskrankheiten der Provinz Madras im 19. Jahrhundert. Er fokussiert auf die so genannten „Gomastah“, eine Klasse von indischen Untergebenen, die zur Aufdeckung der illegalen Prostitution in Madras eingesetzt wurden, um so die Ausbreitung von Geschlechtskrankheiten zu verhindern. Untersucht wird auch die Rolle anderer einheimischer und nicht einheimischer Untergebener wie der Dhais, Chowdranies und Matrons, die für die reibungslose Umsetzung des Contagious Diseases Act und das alltägliche Funktionieren dieser Krankenhäuser unverzichtbar waren. Indem herausgearbeitet wird, wie indisches Kastendenken in die koloniale Gouvernementalität einfließen konnte und so koloniale Vorurteile und Xenophobie stärkte, unterstreicht der Artikel die Tatsache, dass es keine einseitige Aneignung oder Vermittlung kolonialen Wissens und kolonialer Vorannahmen durch die kolonisierten Vermittler gab. Argumentiert wird vielmehr für deren Interaktion, betont wird die komplexe Bedeutung des Kastensystems und seiner Vorurteile für das alltägliche koloniale Regierungshandeln. Zudem befasst sich der Beitrag mit dem daraus resultierenden Chaos und den inhärenten Machtkämpfen zwischen verschiedenen Gruppierungen des kolonialen Personals. (shrink)

Most histories of livestock disease in Britain treat the development of control policy as a government responsibility, to which farmers made little constructive contribution. Similarly, farmers rarely appear in accounts of disease research. This paper uses the example of contagious abortion at the turn of the twentieth century to reveal that state-farming collaboration in research and policy did in fact occur, and that it operated in various ways, with often unexpected outcomes. The collaborative approach to contagious (...) abortion is partly attributed to its clinical and epidemiological features, which made it an unsuitable candidate for the existing, state-led policy of stamping out disease. It is claimed that such collaboration has been overlooked by historians on account of their focus upon diseases that were amenable to stamping out. This focus needs to change if history is to inform present-day disease governance in Britain, which is founded on the concept of ‘partnership’ between farmers and the state. (shrink)

Cancer is generally defined as uncontrollable growth of cells caused by genetic aberrations and/or environmental factors. Yet contagious cancers also occur. The recent emergence of a contagious cancer in Tasmanian devils has reignited interest in transmissible cancers. Two naturally occurring transmissible cancers are known: devil facial tumour disease and canine transmissible venereal tumour. Both cancers evolved once and have then been transmitted from one individual to another as clonal cell lines. The dog cancer is ancient; having evolved (...) more than 6,000 years ago, while the devil disease was first seen in 1996. In this review I will compare and contrast the two diseases focusing on the life histories of the clonal cell lines, their evolutionary trajectories and the mechanisms by which they have achieved immune tolerance. A greater understanding of these contagious cancers will provide unique insights into the role of the immune system in shaping tumour evolution and may uncover novel approaches for treating human cancer. (shrink)

Modelling of contagious disease usually employs compartmental SEIR-like models where the waiting times in respective compartments are exponentially distributed. In this paper, we are interested in investigating how the distributions of sojourn times in infective compartments affect the dynamics and persistence of the contagious bovine pleuropneumonia, a chronic respiratory disease of cattle. Two kinds of extreme distributions of the sojourn times are considered: a Dirac delta-function and truncated Gaussian function leading to a model with (non-constant) delay (...) and the classical exponential distribution that stands for a model without delay. Expressions of the basic reproductive numbers are derived and dynamical behaviours are discussed for the three models. It is found that the spreading of disease exhibits wave-like oscillations for the time-delay dynamics. In contrast, the disease appears to last longer when the spreading is described by the classical dynamics without delay. Subsequently, the time-delay dynamics turns out to be more appropriate for the description of an experimental epidemic of CBPP. (shrink)

The highly contagious 2019 novel coronavirus disease (COVID-19) outbreak has not only impacted health systems, economies, and governments, it has also rapidly grown into a global health crisis, which is now threatening the lives of millions of people globally. While, on one hand, medical institutions are critically attempting to find a cure, on the other hand, governments have introduced striking measures and policies to curtail the rapid spread of the disease. Although COVID-19 has achieved pandemic status and (...) is predominantly viewed as a biomedical issue, it is argued that it should also be treated as a psychological crisis. This paper also reviews the literature to examine and comment on the detrimental effects of isolation, which has been enforced as one of the primary preventative measures to manage the spread of COVID-19. This paper further outlines key recommendations that should be addressed across different levels to buffer against the known adverse effects of isolation, which is especially relevant for the current COVID-19 situation, where a large proportion of the global population is isolated, confined, and/or quarantined. (shrink)

ABSTRACT This paper is concerned with landmarks in the history of the idea of cancerous contagiousness from the Renaissance to the Enlightenment. The origins of the idea of cancerous contagiousness is considered on the basis of Galen’s distinction between scabiesleprosy, cancer and elephantiasis. Paul of Aegina (seventh century) established the association between these latter diseases. In the fourteenth century, a ‘new line of inquiry’ developed concerning the transmission of diseases like plague, and G. Fracastoro (1546) applied this approach by stating (...) that putrefaction and inflammation notably produce elephantiasis, which is obviously contagious, as inflammation and heat, without putrefaction, produce cancer. J. Fernel (1548) applied the process of syphilitic contamination to ulcerated cancer, whose vapour ‘is widely dispersed’ and which ‘quickly kills by its malignancy’. G. Cardano (1564) reacted against these views, and declared that cancer was could not be transmitted by contact. But A. Zacuth (1629–1634) and N. Tulp (1652) provided instances of such transmission. D. Sennert, who is often said to have accepted Zacuth’s testimony, was doubtful and suggested, rather than contagion, transmission by heredity. This type of explanation was privileged during Classical Age, until experiments on animals or human beings infected by cancerous liquid took place during the Enlightenment in France and England. Pichler (1786) finally recommended forbidding marriage between people suffering from cancer. (shrink)

Animal health is key to successful livestock production in developing countries. The development and delivery of vaccines against major epidemic diseases is one component of improving animal health. This paper presents a case study from Kenya on the production and delivery of a vaccine against Contagious Caprine Pleuropneumonia (CCPP), a major disease of goats. The vaccine, while technically a viable preventative measure against CCPP, has not been well integrated into Kenya's animal health care system. From February through November, (...) 1992, the authors explored the organizational and policy constraints to vaccine production and distribution. Data were obtained through interviews, field visits, and available documents. Results suggest an animal health system that 1) does not have a well developed infrastructure to track, identify, and control animal diseases; 2) tends to place greater emphasis on cattle, rather than small ruminant health care; and 3) is not well linked in terms of research, development, and extension services. (shrink)

The novel coronavirus disease has become a global pandemic, causing substantial anxiety. One potential factor in the spread of anxiety in response to a pandemic threat is emotion contagion, the finding that emotional experiences can be socially spread through conscious and unconscious pathways. Some individuals are more susceptible to social contagion effects and may be more likely to experience anxiety and other mental health symptoms in response to a pandemic threat. Therefore, we studied the relationship between emotion contagion and (...) mental health symptoms during the COVID-19 pandemic. We administered the Emotion Contagion Scale along with a measure of anxiety in response to COVID-19 and secondary outcome measures of depression, anxiety, stress, and obsessive-compulsive disorder symptoms. These measures were completed by a large student sample in the United States. Data were collected in the months of April and May of 2020 when the fear of COVID-19 was widespread. Results revealed that greater susceptibility to emotion contagion was associated with greater concern about the spread of COVID-19, more depression, anxiety, stress, and OCD symptoms. Consumption of media about COVID-19 also predicted anxiety about COVID-19, though results were not moderated by emotion contagion. However, emotion contagion did moderate the relationship between COVID-19-related media consumption and elevated OCD symptoms. Although limited by a cross-sectional design that precludes causal inferences, the present results highlight the need for study of how illness fears may be transmitted socially during a pandemic. (shrink)

This study details the methodological process for creating a tool for the identification of COVID-19 potential contagion situations in sports and physical education before, during, and after practice and competition. It is a tool that implies an educational and methodological process with all the agents of the sports system. This tool identifies the large number of interactions occurring through sports action and everything that surrounds it in training, competition, and organization. The aim is to prepare contingency protocols based on an (...) exhaustive analysis, risk detection, and proposal of contingency measures trying to reduce the residual risk to a minimum. In the second part, the results of the implementation of this tool in the sports system of Galicia (Spain) are shown. The technicians have changed their perceptions about the coronavirus transmission in sports. They highlight the problem for returning to sports participation for athletes under 18 years in the pandemic context. (shrink)

In spite of extensive criticisms, war metaphors are still widespread in medical discourse. In the domain of public health analogies between war and infectious diseases are rooted in the similar impacts they can have on political institutions and communities. This similarity has been emphasized by the recent trend of addressing infectious disease from the point of view of national security. Nevertheless, it is here argued that the analogy cannot be used to model normative principles for treating carriers of (...) class='Hi'>contagious diseases after the principles of ius in bello . Yet, the analogy may provide some useful practical and theoretical insights in tackling the growing problem of limiting the spread of drug-resistant pathogens: an issue that generates increasing worries and raises difficult ethical and political questions of rights, responsibilities and obligations. It is suggested that if anti-microbials and antibiotics are seen as strategic information, their misuse can be usefully compared to careless talk in times of war. (shrink)

This essay examines President Nixon's drug policy during the early 1970s, specifically the government's reaction to heroin use by American soldiers in Vietnam. The official response, discursively (through the employment of the drugs-as-a-disease metaphor) and on the policy level illustrated how of issues of national- and self-identity othering, and modernity intersected in the formulation and implementation of what is now termed the Drug War. Heroin using soldiers and domestic addicts, labeled as carriers of a contagious, foreign, and antimodem, (...) dangerous disease, threatened to undermine a contingent national identity an identity weighted by capitalist modernity. Unearthing how addiction's ostensibly antimodern condition contributed to the othering of addicts as a foreign danger reveals how the United States' antidrug character and policies help maintain a national identity bound to the tenets of capitalist modernity. Methodologically, this essay combines historical analysis with literary and critical theory. (shrink)

Communicable diseases, especially those that are highly contagious, are on the rise and each of us, no matter who we are or where we live, is equally at risk of transmitting contagious diseases to others as we are of contracting such diseases from others. Because contagious diseases are as readily passed state-to-state as person-to-person, we all have a stake in every country's ability to enact effective infectious disease control policies, while policies grounded in shared values are (...) more likely to gain widespread acceptance and thereby prove most effective. This paper suggests that principlism proved invaluable as an ethical framework for resolving hard medical cases and setting health care policy because it nicely “fits” dilemmas that arise in the context of the special relationship between doctors and patients or within family units. It then argues that communitarianism provides the better foundation for crafting infectious diseases control policies because contagious diseases, which often pass between perfect strangers, raise questions about the moral obligations we owe to (or are entitled to demand of) people with whom we share no “special” relationship. Accordingly, a socially embedded framework such as communitarianism may be a better fit for the more socially embedded ethical dilemmas of communicable diseases. (shrink)

Communicable diseases, especially those that are readily contagious, are on the rise as evidenced by the emergence of viruses like severe acute respiratory syndrome, the global resurgence of resistant forms of ancient mycobacteria such as extensively drug resistant tuberculosis, and the 2009 swine flu outbreak in Mexico. Moreover, each of us, no matter who we are or where we live, is just as likely to transmit contagious diseases to others as we are to contract such diseases from others. (...) As cogently described in the title of a recent book by Margaret Battin et al., we are all potential “victims and vectors.”Just as contagious diseases are readily passed person to person, so too can they readily be passed across local and national boundaries. We therefore all have a stake in the development of effective infectious disease control policies on a national scale, with “effective” being the operative term: regulations and statutes that are neither enforceable nor likely to be complied with may do more harm than good. (shrink)

When labeling an infectious disease, officially sanctioned scientific names, e.g., “H1N1 virus,” are recommended over place-specific names, e.g., “Spanish flu.” This is due to concerns from policymakers and the WHO that the latter might lead to unintended stigmatization. However, with little empirical support for such negative consequences, authorities might be focusing on limited resources on an overstated issue. This paper empirically investigates the impact of naming against the current backdrop of the 2019–2020 pandemic. The first hypothesis posited that using (...) place-specific names associated with China leads to greater levels of sinophobia, the negative stigmatization of Chinese individuals. The second hypothesis posited that using a scientific name leads to increased anxiety, risk aversion, beliefs about contagiousness of the virus, and beliefs about mortality rate. Results from two preregistered studies [N = 504; N = 412], conducted across three countries with the first study during the early outbreak and the second study at a later stage of the pandemic, found no evidence of any adverse effects of naming on sinophobia and strong support for the null hypothesis using Bayesian analyses. Moreover, analyses found no impact of naming on anxiety, risk aversion, beliefs about contagiousness of the virus, or beliefs about mortality rate, with mild to strong support for the null hypothesis across outcomes. Exploratory analyses also found no evidence for the effect of naming being moderated by political affiliation. In conclusion, results provide no evidence that virus naming impacted individual’s attitudes toward Chinese individuals or perceptions of the virus, with the majority of analyses finding strong support for the null hypothesis. Therefore, based on the current evidence, it appears that the importance given to naming infectious diseases might be inflated. (shrink)

The controversy surrounding the use of hydroxychloroquine, an antimalarial drug, for COVID-19 has raised numerous ethical and policy problems. Since the suggestion that HCQ has potential for COVID-19, there have been varying responses from clinicians and healthcare institutions, ranging from adoption of protocols using HCQ for routine care to the conduct of randomised controlled trials to an effective system-wide prohibition on its use for COVID-19. In this article, we argue that the concept of ‘disease public profile’ has become a (...) prominent, if not the sole, determinant in decision-making across various healthcare responses to the pandemic. In the case of COVID-19, the disease’s public profile is based on clinical and non-clinical factors that include contagiousness, clinical presentation and media coverage. In particular, we briefly examine the dangers of a heightened public profile in magnifying the inequality of diseases and undermining three key ethical concepts, namely evidence-based practice, sustainable allocation and meaningful consent. (shrink)

Dans le cadre de son analyse de la biopolitique, Michel Foucault avance que le développement de ce mode de contrôle sur la vie est contemporain de celui de l’utilitarisme et du libéralisme et qu’il a trouvé dans ces nouveaux cadres de la rationalité politique une caution théorique. Pour mettre en évidence la nature exacte des rapports entre biopolitique, utilitarisme et libéralisme, il est utile de s’intéresser à un épisode de l’histoire de la santé publique anglaise, à savoir la campagne pour (...) l’abrogation des Contagious Diseases Acts à la fin des années 1860. On essaiera de montrer comment, dans les objections qu’il adresse à ces dispositions, l’utilitariste libéral John Stuart Mill a articulé motifs utilitaires et motifs libéraux quand s’est posée la question du rapport entre libertés individuelles et bien-être social.In the course of his analysis of biopolitics, Michel Foucault maintains that the development of this new mode of control over life is contemporaneous with the rise of utilitarianism and liberalism and that biopolitics found in these new frameworks of political rationality a theoretical rationale. In order to show the exact nature of the relations between biopolitics, utilitarianism and liberalism, it is useful to consider one episode in the history of English public health, namely the campaign for the abrogation of the Contagious Diseases Acts at the end of the 1860s. I will try to show how, in the objections he addressed to these provisions, John Stuart Mill has articulated utilitarian and liberal tenets when the issue of the relations between the freedom of individuals and social well being was raised. (shrink)

For contagious diseases like measles a successful immunization program can result in herd protection. Small outbreaks may still occur but fade out soon, because the possibilities for the pathogen to spread in the ‘herd’ are very small. This implies that people who refuse to participate in such a program will still benefit from the protection it offers, but they don’t do their part in maintaining protection. Isn’t that a case of freeriding—and isn’t that unfair towards all the people who (...) do collaborate? If so, that might be considered an additional ground for making vaccination mandatory or compulsory.In this paper I argue that vaccination refusal can be considered as freeriding, but that this might not be unfair. The public good of herd protection is a peculiar public good because it supervenes on private benefits that are enjoyed by all who do opt for vaccination. For vaccinated individuals, the additional benefit of herd protection comes about, as it were, for free, and hence they can’t complain that others benefit without sharing in the burdens. There are however still other grounds for making vaccination compulsory or at least for seeing refusal as a morally wrong choice. (shrink)

Background:As a highly contagious disease, the COVID-19 pandemic has become a serious health threat and psychological burden for the global communities. From the conceptual perspective of affordances, this research examined the role of social media for health campaign and psychological support during the global crisis.Methods:Data from both social media and a nationwide survey were collected and analyzed. Face mask-related posts on Sina Weibo from January 1, 2020, to June 30, 2020, were retrieved and studied. Face mask wearing as (...) a well-established preventive measure was identified and examined from hashtag topics. A nationwide survey with a randomized experiment embedded was conducted to further investigate the mobilizing dynamics.Results:During the escalation phase in the first half of 2020, the hashtag topic “#national mask campaign#,” initiated by a celebrity, topped the ranking of mask-related topics on Weibo. The findings indicated that prevention activities, solidarity expression, and names of celebrity idols were frequently discussed. With celebrity idols as opinion leaders, millions of fandom publics actively participated in this hashtag health campaign. Results of the nationwide survey show the popularity of fan identity, and the experiment results demonstrate the strong mobilizing power of celebrity idol and fandom community in civic engagement and participation among young Chinese.Conclusions:The research demonstrates how the affordances of social media, such as liking, commenting, reposting, and hashtagging can be influential in promoting health behaviors and expressing solidarity. Implications for public health professionals and policymakers to raise awareness and understanding about health campaigns via social media are discussed. (shrink)

Acclaimed cultural critic Curtis White examines current fissures in Western Buddhism and argues against the growth of scientific and corporate dharma, particularly in Stephen Batchelor's Secular Buddhist movement. In Transcendent, celebrated cultural critic Curtis White, asks what Buddhism will look like in the future. Do we want a secular Buddhism that looks like corporations and neuroscience? Or do we want a Buddhism that still provides refuge from the debased world of money and things? Transcendence is not about magic realms where (...) spirits fly about; the world is, as Shunryu Suzuki put it, its own magic. We only need to reclaim it and reclaim our humanity while we’re at it. The problem White suggests is a culture that recognizes only "things," capitalist things and science things, and aggressively denies the idea that the world of things has a beyond. We're told by science ideologues like the New Atheists that we live in a secular age and that philosophy is dead, and art is only an amusement, and transcendence is not wanted because science can provide all the wonder and beauty we need. Transcendent is a call for the re-enchantment not only of Buddhism but also of our Western art traditions. White recalls the risks and the raptures of the English Romantics, Beat poets, and the children of the counterculture, all in the name of a living world, and in defiance of our current world of climate catastrophe, contagious disease, and social collapse. (shrink)

Vaccine refusal occurs for a variety of reasons. In this article we examine vaccine refusals that are made on conscientious grounds; that is, for religious, moral, or philosophical reasons. We focus on two questions: first, whether people should be entitled to conscientiously object to vaccination against contagious diseases ; second, if so, to what constraints or requirements should conscientious objection to vaccination be subject. To address these questions, we consider an analogy between CO to vaccination and CO to military (...) service. We argue that conscientious objectors to vaccination should make an appropriate contribution to society in lieu of being vaccinated. The contribution to be made will depend on the severity of the relevant disease, its morbidity, and also the likelihood that vaccine refusal will lead to harm. In particular, the contribution required will depend on whether the rate of CO in a given population threatens herd immunity to the disease in question: for severe or highly contagious diseases, if the population rate of CO becomes high enough to threaten herd immunity, the requirements for CO could become so onerous that CO, though in principle permissible, would be de facto impermissible. (shrink)

Humans have been using fire for hundreds of millennia, creating an ancestral expansion toward the nocturnal niche. The new adaptive challenges faced at night were recurrent enough to amplify existing psychological variation in our species. Night-time is dangerous and mysterious, so it selects for individuals with higher tendencies for paranoia, risk-taking, and sociability. During night-time, individuals are generally tired and show decreased self-control and increased impulsive behaviors. The lower visibility during night-time favors the partial concealment of identity and opens more (...) opportunities for disinhibition of self-interested behaviors. Indeed, individuals with an evening-oriented chronotype are more paranoid, risk-taking, extraverted, impulsive, promiscuous, and have higher antisocial personality traits. However, under some circumstances, such as respiratory pandemics, the psychobehavioral traits favored by the nocturnal niche might be counter-productive, increasing contagion rates of a disease that can evade the behavioral immune system because its disease cues are often nonexistent or mild. The eveningness epidemiological liability hypothesis presented here suggests that during the COVID-19 pandemic, the evening-oriented psychobehavioral profile can have collectively harmful consequences: there is a clash of core tendencies between the nocturnal chronotype and the recent viral transmission-mitigating safety guidelines and rules. The pandemic safety protocols disrupt much normal social activity, particularly at night when making new social contacts is desired. The SARS-CoV-2 virus is contagious even in presymptomatic and asymptomatic individuals, which enables it to mostly evade our evolved contagious disease avoidance mechanisms. A growing body of research has indirectly shown that individual traits interfering with social distancing and anti-contagion measures are related to those of the nocturnal chronotype. Indeed, some of the social contexts that have been identified as superspreading events occur at night, such as in restaurants, bars, and nightclubs. Furthermore, nocturnal environmental conditions favor the survival of the SARS-CoV-2 virus much longer than daytime conditions. We compare the eveningness epidemiological liability hypothesis with other factors related to non-compliance with pandemic safety protocols, namely sex, age, and life history. Although there is not yet a direct link between the nocturnal chronotype and non-compliance with pandemic safety protocols, security measures and future empirical research should take this crucial evolutionary mismatch and adaptive metaproblem into account, and focus on how to avoid nocturnal individuals becoming superspreaders, offering secure alternatives for nocturnal social activities. (shrink)

One of the most prevalent rationales for public healthcare policies is a human right to healthcare. Governments are the typical duty-bearers, but they differ vastly in their capacity to help those vulnerable to serious health problems and those with severe disabilities. A right to healthcare is out of the reach of many developing economies that struggle to provide the most basic services to their citizens. If human rights to provision of such goods exist, then governments would be violating rights without (...) doing anything wrong. I argue that such variable ability to provide healthcare depends not only on financial resources, but on institutional capacity, and that the latter represents a more fundamental challenge to the existence of a human right to healthcare than previously recognized. This challenge does not imply that government has no obligations to protect and improve the health of their citizens, but that it is best to think of such obligations as generated by conventional rights, namely rights arising from local legal and social conventions, which require governments to pursue health-related moral goals such as reducing suffering, closing opportunity gaps for the disadvantaged, and preventing the spread of contagious diseases. We need not think of such moral goals in terms of human rights. (shrink)

Mass vaccination has been a successful public health strategy for many contagious diseases. The immunity of the vaccinated also protects others who cannot be safely or effectively vaccinated—including infants and the immunosuppressed. When vaccination rates fall, diseases like measles can rapidly resurge in a population. Those who cannot be vaccinated for medical reasons are at the highest risk of severe disease and death. They thus may bear the burden of others' freedom to opt out of vaccination. It is (...) often asked whether it is legitimate for states to adopt and enforce mandatory universal vaccination. Yet this neglects a related question: are those who opt out, where it is permitted, morally responsible when others are harmed or die as a result of their decision? In this article, we argue that individuals who opt out of vaccination are morally responsible for resultant harms to others. Using measles as our main example, we demonstrate the ways in which opting out of vaccination can result in a significant risk of harm and death to others, especially infants and the immunosuppressed. We argue that imposing these risks without good justification is blameworthy and examine ways of reaching a coherent understanding of individual moral responsibility for harms in the context of the collective action required for disease transmission. Finally, we consider several objections to this view, provide counterarguments and suggest morally permissible alternatives to mandatory universal vaccination including controlled infection, self-imposed social isolation and financial penalties for refusal to vaccinate. (shrink)

Physicians and institutional providers face expanding liability exposure today, in spite of state tort reform legislation and public awareness of the costs of malpractice for providers. Standards of practice are evolving rapidly; new medical technologies are being introduced at a rapid rate; information is proliferating as to treatment efficacy, patient risk, and diseases generally. Tort standards mirror this change. As medical standards of care evolve, they provide a benchmark against which to measure provider failure. The liability exposure of physicians is (...) affected by the generation of data, including outcomes data usable to profile physician practice, and statistical data that allows for predictions as to treatment efficacy, and patient prognosis; obligations to inform patients and third parties of risk created by contagious disease and other sources of harm; obligations of physicians to disclose risks that the provider creates for the patient; obligations to disclose conflicts of interest arising out of the practice setting; and duties arising from new epidemiological knowledge. (shrink)

Poreskoro, with three cat and four dog heads and a snake with a forked tongue as his tail, is responsible for epidemics of contagious diseases in Romany folklore. The Pishachas of Vedic mythology lurk in charnel houses and graveyards, waiting for humans to infect with madness. In Christian demonology, Pythius is known as the ruler of the eighth circle of the Inferno, bestowing heinous and unspeakable tortures on those who have committed fraud. Demons are the stuff of legends, and (...) they are everywhere in mythology and theology. These are just three of the more than thirty I counted that start with the letter P.How lucky we are for the advent of science. A rational tonic, it scatters our demons, demystifying the world for us—or so, at least, we think. As Canales brilliantly shows in this book, our assumption has been far off the mark. In physics, computer science, genetics, neuroscience, and economics, not to mention in the very foundations of rationality itself, an underworld of imaginary creatures has sustained and continues to inhabit modern science. Scientific demons appear in many guises: as atomic and subatomic particle manipulators, as feedback and parallel-processing experts, as messengers who can travel faster than the speed of light, as computer-code spies, gene and bit selectors in evolution and in informatics, as triggers of cascades from the nano level to the level of full-blown ecological and astrophysical theaters. By inventing them, we have learned that causality does not always hold at the level of atoms, that the speed of message transmission is limited, that living systems spend energy, that perpetual-motion machines are impossible, and that there are corners of the universe we have not imagined.We have all heard of Laplace's Demon, and Maxwell's, but who knew that, borrowing from physics, the historian Henry Adams considered the action of demons in geopolitics or that the economist Paul Samuelson analyzed their role in producing more efficient markets? Who knew that the generation that gave us the Internet and artificial intelligence were tasked by their teachers in graduate school to insert as many demons as possible into their programs? Who among us has heard of Darwin's Demon, or Maxwell-Szilárd-Brillouin's, or Monod's, or Loschmidt's? Who is aware of Norbert Weiner's use of demons in conceptualizing cybernetics, or of the great scholar of Kabbalah Gershom Scholem's comparison between Israel's superfast computers and the Golem?As Canales shows convincingly, it has been difficult for both historians and scientists to countenance demons in science, and so they have been written out, in many ways and many instances, of the histories of which they are part and parcel. Thomas Kuhn and even the more radical philosopher Paul Feyerabend both failed to acknowledge in their social critiques of science the extent to which an imaginary underworld of beings has been constitutive of the modern scientific imagination. Ironically, it was the man who provided a hard-and-fast criterion by which to distinguish scientific and nonscientific pursuits, Karl Popper, who ultimately saw the light. Revisiting his classic book The Logic of Scientific Discovery from 1934, he clarified in Postscript to the Logic of Scientific Discovery in 1982 the extent to which every historical era has been characterized by a particular demon. We moderns believe that science is about facts and numbers, but we are mistaken. As Canales beautifully summarizes the stakes of her project, “What first sets science on its path of discovery—then as now—is the continued use of the imagination.”Tracking the fate of demons in modern thought from Descartes to Lord Kelvin to H. G. Wells to David Bohm, and from Conrad Hal Waddington to Henry Compton to Stephen Hawking and Steven Pinker, Bedeviled assumes that the demons of the church or of paganism and the demons of science differ and resemble each other in ways that can be usefully elaborated. What is more crucial, however, is how such demons become real, how they morph from fears to hopes, and from thought experiments into real experiments, and ultimately to things in this world like computer programs, transistors, and nanorobots. From weather systems to messenger RNAs to black holes, demons emerge everywhere. The hard question is: How does the imagination actually drive discovery and understanding? How does it change our world?Perhaps it has been a sidetrack to consider whether we have or have never been modern. Clearly, what reason will not allow, it perennially recruits for a shadowland that helps us to better see our world. Rather than aiming to exorcise science, one day, of all of its methodological and epistemological ghosts, perhaps we might make peace with the notion that every culture struggles with distinguishing truth from falsehood in its own unique way. Such struggles are sensitive to their times and are accomplished through leaps of imagination. But fear not: the debunking of “Western rationality” casts no wet blanket on the project of Enlightenment. If anything, as Canales writes, “an account of science that considers how scientists themselves do science only risks adding new insights into our repertoire of knowledge.” Perhaps, therefore, there is solace to be gained from the dictum, Always choose the Devil you know. Ultimately, there may be no other way forward. (shrink)

Of John Stuart Mill's major commitments, none was more passionately pursued than equality; it marks his writings throughout his life, and serves as a uniting force in his comments on many subjects, especially lawand education. This volume presents, in scholarly form for the first time, writings that reveal his goals and methods in diverse circumstances. They begin with his precocious essay on the law of libel and include his influential Subjection of Women, his major essays on slavery, his Inaugural Address (...) at St Andrews, and his contributionsin the struggle to being Governor Eyre of Jamaica to trial. A variety of shorter essays is also presented: such personal documents as his declaration just before amrriage renouncing all legal rights over his wife, and his and Harriett Taylor's companion pieces on marriage, newly edited from manuscript. Also included is Mill's evidence before parliamentary committees on education and the Contagious Diseases Acts. The appendices include ancillary texts and a bibliographic index listing all works and persons mentioned or quoted in the essays. An analytic index gives easy access to the full range of Mill's ideas in these important essays. (shrink)

Home diagnostic testing is becoming part of the modern medical landscape, but many ethical and policy questions remain unresolved. Most of them first surfaced during the long regulatory deliberations over the home HIV test, the first home test for a contagious illness sold in the United States. Between 1989 and 2012, federal regulators and their consultants debated the ideal metrics for such a test, its benefits, and its potential harms for both individuals and communities. Ultimately, two iterations of the (...) home HIV test were marketed in the United States; neither one of them changed the course of the national HIV epidemic, as hoped. This failure has powerful implications for home testing for other contagious diseases. (shrink)

For over a century, a foreign national seeking permission to immigrate to the U.S. could have her application for immigration denied on the ground that she suffers from a serious contagious disease. For just under two decades, a foreign national seeking permission to immigrate could also have her application denied on the ground that she has not been vaccinated against each of a list of vaccination-preventable diseases. Two recently developed moral justifications for the use of such “vaccination-related exclusion (...) criteria” have focused on (a) the right and need of a society to prevent the spread of disease to others and (b) the public good of developing and protecting herd immunity. Herein I accept these two general justifications—especially as they are developed by Mark Navin—and explore their limits. In particular, with a focus on the recently developed vaccine against several strains of HPV, as well the short-lived requirement by the CDC that it, too, be required of prospective immigrants, I argue that neither of the two main justifications for the use of vaccination-related exclusion criteria support their use for diseases such as HPV (or even HIV), the transmission of which, unlike airborne diseases such as measles, pertussis and polio, is subject to a considerable degree of individual control. (shrink)

During the night of August 2nd to 3rd 1939, the American anthropologist Buell Quain, then working among the Krahô Indians, lacerated his body, opened his veins and ended up hanging himself from a tree by using a rope from his hammock. In several letters dated 2nd August 1939 which he had written and left for his usual correspondents, he mentions a contagious disease to explain his final act. But this reason would be contradicted by many of his last (...) comrades and colleagues. This paper aims to investigate elements that contribute to the understanding of the links between the fieldworker and his subject. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Curative Work:Dana's Two Years Before The MastAllan Christensen (bio)In narrating his voyage out from Boston on the Pilgrim and his voyage home on the Alert, Richard Henry Dana, Jr., encourages an ambivalent interpretation of the experience. As one possibility, contagious sickness and forms of bondage characterize the culture of home, whereas the sailor's condition and less civilized sites offer health, romance, and freedom. But an opposite possibility is (...) that the ship resembles an unhealthy prison and the foreign settings are spoiled, and so hope resides in the curative power still emanating from the civilization of home. The two possibilities may relate to the Goethean-Carlylean pattern of Bildung, whereby the protagonist initially rebels and escapes from home but later repents and returns, recognizing that his America must be "here or nowhere" (Carlyle 1899, 156),1 in Massachusetts rather than in California. Dana indeed desires first to become entirely the sailor but then in terror before that eventuality desires to return to his identity as a Harvard scholar. With respect to the motif of literacy, the initial effort to live fully amid the bracing energies of winds and sea gives way to an appreciation of the curative force of reading and writing books. Yet the two phases are not after all so neatly opposed and divided between two halves of the story. They coexist in a tension that is sometimes also resolved.In 1842, two years after publishing Two Years before the Mast, Dana began to compose "An Autobiographical Sketch, 1815–1841." This "Sketch" (1968) creates a context for the previously published work that justifies the first of the two interpretations. His early life has already featured, in the "Sketch," many incidents of wandering away from home and of rebellion against the restrictions and injustices of society. The turbulent young protagonist especially resents the tyranny of the schoolmasters who administer floggings and later the tyranny of the authorities at Harvard College who unfairly punish a classmate. In response to this latter incident, Dana's own rebellion leads to his suspension from the college for a term, an event that he welcomes as a liberation from an oppressive educational system. The inevitability of his future career as [End Page 219] a lawyer also weighs heavily upon him and probably worsens an incapacitating crisis of 1834. Specifically, the crisis begins with a contagious disease: he catches measles, an illness that triggers a hereditary tendency toward degenerating eyesight, and reading becomes insupportably painful for him. The revulsion against books derives, as Thomas Philbrick suspects, from both physical and psychological causes (1981, 10).2 Dana seeks an occupation that will remove him not only from the necessity of reading but from the debilitating, literate civilization of New England. At this juncture the lure of a sea voyage becomes irresistible:I had many offers of free passage, but I knew a passenger's life would be insupportable without books. Partly from these considerations, but aided very much by the attractiveness of the romance & adventure of the thing, I determined to go before the mast, where I knew that the constant occupation would make reading unnecessary.(Dana 1968, 1:26–27)As opposed to the culture associated with books, the sailor's life offers health as well as romance and freedom. Omitting, then, as unnecessary any account of the intervening events narrated in Two Years before the Mast, the "Autobiographical Sketch" resumes the narrative by restating the opposition:I will take this journal up, again, from the place where my published narration ends. Upon our arrival at Boston on 22 of Sept 1836,... I was very much struck with the pallid & emaciated appearance of the gentlemen I met with, when compared with the rough, sun burnt, hardy faces which I had solely seen for the last five months. If I had been [told] that there had been a famine or fever in the city & that these persons were recovering its effects, I should have said that their appearances indicated it plainly enough. The women looked like mere shades.(Dana 1968, 1:28)In the penultimate chapter of Two Years, one of the pallid, apparently fever-stricken Bostonians had observed, on meeting the... (shrink)

The COVID-19 pandemic requires emergency policies to be put in place in order to avoid a global health catastrophe. At the same time, there has been an increasing preoccupation that argues urgent policies for public health neglect social justice. By looking at Portugal’s successful confinement case during the early stages of the pandemic, I argue that ethically driven social justice policies are not just compatible but also an instrumentally important element in addressing this pandemic in an effective way. The Portuguese (...) case study suggests that enhancing social justice towards socio-economically vulnerable groups correlates with the prevention of the spread of COVID-19; these benefits to public health can be explained by the fact that those policies create social distancing and less exposure to the COVID-19 virus and other contagious diseases and also remove disincentives to the use of healthcare services. (shrink)

For the past 500 years, to varying degrees, the processes of religious secularization have been occurring in what today are the wealthy, highly educated, industrialized nations of the world. They are causing organized religion, as a social institution, to go from being a very important influence on the lives of people and the nations in which they live to being a smaller influence, or almost no influence at all. Various disciplines from theology to psychology to sociology have tried to explain (...) secularization, each discipline contributing something unique. One discipline that has not contributed has been biology. From a biological perspective, based on observation and reasoning, at least one of the ultimate functions of the physical forms associated with religion appear to be that of in-group marker for a breeding population, which, as will be shown, is how all religions start. Religions structure larger human populations into smaller “clusters” that are separate in-group breeding populations. The clustering into smaller in-group breeding populations prevents the spread of contagious diseases and creates inter-group competition and intra-group cooperation, both of which have contributed to human eusociality, a very rare type of social organization that will be explained. As the physical forms of religion are losing this in-group-marker function of clustering populations with modernity, a general biological principle comes into play, which is “form follows function, and as function wanes, so does form.” When applied to religion, “form” means the physical components by which all religions are built. The specific meaning of “physical,” as used here, will be explained in the article. This biological perspective, which is counter-intuitive and can generate testable hypotheses, should complement, not compete, with perspectives from other disciplines. Physical forms in biology can and often do have more than one function, so the same form with a biological function can also have psychological and theological functions. The physical forms of religion are its objects of natural (genetic and cultural) selection. As socio-economic modernity spreads through the world, the evolutionary biological trajectory suggests that religion, as a social institution, will eventually become extinct. (shrink)

Due to the confinement imposed by the COVID-19 pandemic situation, companies adopted remote work more than ever. The rapid rise of remote work also affected local life and many employers introduced or extended their telework activities because of the associated advantages. However, despite the evident positive benefits, some employees were pressured to work remotely while ill. This evidence brought new challenges to the presenteeism literature. This article investigates how individual, economic/societal, and organizational/sectorial/supervisory-related variables can moderate the role of a (...) class='Hi'>contagious disease, such as the COVID-19, in explaining presenteeism behavior. Moreover, the current research presents a multi-level conceptual model to describe how a new construct of remote-work presenteeism behavior mediates the relationship between different post pandemic health conditions and future cumulative negative consequences. The authors suggested that the widespread pervasive adoption of remote work because of COVID-19 has important implications for the presenteeism literature and opens avenues for further research. (shrink)

Revisionists claim that the retributive intuitions informing our responsibility-attributing practices are unwarranted under determinism, not only because they are false, but because if we are all victims of causal luck, it is unfair to treat one another as if we are deserving of moral and legal sanctions. One revisionist strategy recommends a deflationary concept of moral responsibility, and that we justify punishment in consequentialist rather than retributive terms. Another revisionist strategy recommends that we eliminate all concepts of guilt, blame and (...) punishment, and treat dangerous criminals as we treat people with contagious diseases. I argue against both strong and moderate revisionism that it is not unfair to hold persons desert -entailingly responsible insofar as they take an interest in being treated as appraisable, and that it is unfair to persons not to treat them as desert -entailingly responsible contrary to their interests in being treated as such. The interest-based argument, I conclude, give us a justification for communicating retributive attitudes, but may still require a weak revision of our retributive practices, in the direction of a communicative theory of punishment. (shrink)

T. C. Boyle’s A Friend of the Earth (2001), tells the story of Tyrone Tierwater, a one time monkeywrencher and environmental avenger for “E. F.!” (Earth Forever!) who we first meet in 2025 in his mid-seventies. Tierwater is now working for a character based on Michael Jackson, who in his semi-retirement has employed the elder eco-warrior to help save some of the last remnants of a few dying species – warthogs, peccaries, hyenas, jackals, lions and what is likely the last (...) Patagoninan fox. The not too distant environmental future painted by Boyle is a disaster. Global warming has finally caught up to us with a vengeance and even the secure shores of the U.S. are wracked by unmitigated cycles of flooding and drought seriously degrading most semblances of life as we know it. To be sure, though, people, and some versions of progress, go on. While most affordable food and drink is limited to some combination of catfish and sake (very little else having survived decades of disastrous weather and a series of crop blights), and there are constant threats of new strains of life-threatening and highly contagious diseases, suburban development continues and new humans come into existence with the promise, at least in the developed world, of longer life spans. But Boyle does not give us anything like the overly optimistic views expressed by some conservative columnists who dismiss the need for global climate treaties; this is not an environmental future that is only felt with difficulty in the underdeveloped south requiring simpler economic readjustments for Americans without a substantial shift in lifestyle. The world.. (shrink)

John Schellenberg has advanced the hiddenness argument against God’s existence, based on the idea that an all-loving God would seek personal relationships. This paper develops a reply to Schellenberg’s argument by examining the notion of moral impurity, as understood by Paul the Apostle. Paul conceptualized moral impurity as a causal state that transfers from person to person, like a contagious disease. He also believed that moral impurity precludes divine-human relationship. The goal of this paper is to develop these (...) ideas into a problem for one Schellenberg’s key premises. (shrink)

In 1882 Koch discovered the tubercle bacillus and transformed both the medical and the social history of tuberculosis and the experiences of those who contracted it. For the first time, the absence or presence of the bacillus made it possible to define, in Koch’s terms, “the boundaries of the diseases to be understood as tuberculosis.” And for the first time the sick became subject to oversight and discrimination.Prior to Koch’s discovery, tuberculosis, or as it was then called, consumption, was considered (...) a hereditary and non-contagious disease, albeit a very deadly and persistent one. Over the first half of the nineteenth century, it was responsible for one out of every five deaths. It crossed all boundaries of geography, social class, age, and sex affecting residents in rural as well as urban areas, the prosperous as well as the poor, the young even more notably than the old, females more often than males. Physicians assumed a familial predisposition existed ; following the precepts of humoral medicine, they postulated that the disease originated in “irritations” whose sources were to be found in the interaction of an inherited constitution with a particular lifestyle and environment. (shrink)

In 1882 Koch discovered the tubercle bacillus and transformed both the medical and the social history of tuberculosis and the experiences of those who contracted it. For the first time, the absence or presence of the bacillus made it possible to define, in Koch’s terms, “the boundaries of the diseases to be understood as tuberculosis.” And for the first time the sick became subject to oversight and discrimination.Prior to Koch’s discovery, tuberculosis, or as it was then called, consumption, was considered (...) a hereditary and non-contagious disease, albeit a very deadly and persistent one. Over the first half of the nineteenth century, it was responsible for one out of every five deaths. It crossed all boundaries of geography, social class, age, and sex affecting residents in rural as well as urban areas, the prosperous as well as the poor, the young even more notably than the old, females more often than males. Physicians assumed a familial predisposition existed ; following the precepts of humoral medicine, they postulated that the disease originated in “irritations” whose sources were to be found in the interaction of an inherited constitution with a particular lifestyle and environment. (shrink)

We propose that procedures of separation have two functions, namely first, to establish the integrity of individual parts, and second, to make previously joint entities discreet and therefore countable. This allows taking stock of available resources, including evaluating the use of individual objects, a process that is especially adaptive under conditions of threat of contagious disease and resource scarcity.

This note is viewing survival data of a natural cohort as being generated by a possibly nonlinear, nonhomogeneous death process. It proves that the usual conditional distributions of the number of survivors at a certain age are binomial if and only if the death process is linear. Thus the customary statistical methods for the analysis of life table data are, strictly speaking, invalid whenever the underlying death process is nonlinear. For example, if a contagious disease is the cause (...) of some or all of the deaths, the deaths will not be independent and the death process, not linear. One should then base the statistical analysis on a model for the spread of the disease rather than the routine binomial model. (shrink)